Background: Epilepsy is one of the most common serious neurological conditions and 20%to 30% of people with epilepsy have repeated seizures attacks that develop refractory epilepsy .The aim of the present study was to examine the inherited metabolic abnormalities in children with refractory epilepsy to provide early etiological and symptomatic treatment. Patients are to have refractory epilepsy if the application of two types of appropriate and tolerable antiepileptic drugs failed to completely prevent epileptic seizure following adequate duration of treatment and adequate doses of drugs Refractory epilepsy always has been a problematic issue in neurology particularly in the infantile period when the brain of children develops rapidly. An increasing number of children with refractory epilepsy are mainly focused on hereditary metabolic disorder .Since most inherited metabolic disorder are lacking in specific symptom, they are easily ignored or missed in clinical diagnosis. Methods: This study was applied to forty eight patients with refractory epilepsy by application of urine metabolic screen by using urine test strips ,Benedict test, ferric chloride test, Nitrosonaphthol test,Cyanide-nitroprusside test,2. 4 dinitrophenyl hydrazine test. Result: In our study regarding urine screening tests 42% of our cases had presented positive results in at least one of the urine screening tests. This denotes the importance of urine screening tests for early detection of metabolic diseases among cases of refractory epilepsy. Conclusion :Compared with the positive rate of the urine metabolic screening tests in high risk infants suggest probability of the presence of a metabolic disease, which will need further investigations